Sandra West | The University of Sydney (original) (raw)

Papers by Sandra West

Introduction: Despite improvements in revascularization, major amputation remains a significant p... more Introduction: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). Aim: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. Method: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed. Findings: Twenty-five patients had 29 major amputations including four conversions from below to above knee. Seventeen had multiple vascular procedures before amputation. The average LOS exceeded the national target, and there was substantial morbidity and 30-day mortality. Conclusion: Major amputation continues to present challenges because of patient frailty and the high rate of complications. These issues need to be considered in a robust care planning framework that includes consideration of cognitive decline and other markers of frailty. Opportunities to optimize the physical condition of these patients and to reduce delays in proceeding to surgery require further investigation. (J Vasc Nurs 2017;35:49-56)

Journal of the American College of Cardiology, 2014

International Journal of Health Care Quality Assurance, 25(6), 532 - 548

PURPOSE: The purpose of this paper is to describe the use of a common qualitative data set analys... more PURPOSE: The purpose of this paper is to describe the use of a common qualitative data set analysed with both a quality improvement tool to facilitate service improvement, and a rigorous research methodology to engage beginning nurse researchers in a mentored project.
DESIGN/METHODOLOGY/APPROACH: A qualitative cohort study of the experience of hospitalisation across six diagnostic groups interrogated data from 104 patient and carer interviews using the Picker Dimensions of Experience and Heideggerian Phenomenology.
FINDINGS: The paper reveals that well-conducted qualitative interviews can provide common ground for service improvement initiatives and rigorous research analysis.
RESEARCH LIMITATIONS/IMPLICATIONS: The Picker Dimensions use simple coding methods that push findings towards utility, but at times are overly reductionist and exile any data not related to hospital services. Heideggerian phenomenology is training and resource intensive, but its exploration of the meaning of the illness experience provides a profound backdrop for the subsequent understanding of hospitalisation.
PRACTICAL IMPLICATIONS: The access that qualitative data provides to the patient and family's perspective is becoming increasingly valued in processes of ongoing quality improvement, clinical redesign and evaluation for hospital accreditation.
SOCIAL IMPLICATIONS: The intrinsic rewards of deep qualitative analysis for the staff involved are extraordinary. Clinicians were humbled by new understandings, which surprised them despite their long clinical experience.
ORIGINALITY/VALUE: While quality improvement processes require training, ethics applications and data collection, the same framework can support rigorous qualitative research through use of the data as "common ground". The researchers experienced a tension, but eventually, a balance between the strengths and limitations of these combined modes of qualitative inquiry:

Background: The transition to practice of (novice) Registered Nurses (RNs) is commonly seen as a ... more Background: The transition to practice of (novice) Registered Nurses (RNs) is commonly seen as a simple process of “sliding” from one role to the other–Student Nurse (SN) to RN. How novice RNs accomplish moving from performing the role of SN to that of RN however, is rarely examined. Objective: To differentiate the performative roles of SNs and novice RNs.

Methods: Design: Interpretive qualitative design involving three sequential in-depth interviews during participants’ first year of practice; Setting: Australian metropolitan acute care hospitals; Participants: Nine Australian novice RNs; Procedure: Emergent themes were identified using constant comparative analysis and further conceptualised through development of a series of diagrams to determine how elements of these transition experiences might interact. Results: SNs rarely see the reality of performing as a novice RN until the role is actually upon them. While inextricably linked, these performances have become conflated into a conceptual continuum preventing acknowledgement of what are two distinct roles. Irving Goffman’s dramaturgical work was used to develop emergent understandings of how both SN and RN roles were each distinctly rehearsed and performed. Margaret Archer’s “inner conversation” was then used to develop an understanding of how novice RNs move between these roles.

Conclusions: Rather than assuming that SNs will adapt seamlessly to practice as novice RNs, attention needs to be given to differentiating the start and endpoints of this significant transition. Doing so will provide clarity around what educators expect of both roles and help those engaged in this transition to practice to celebrate their successes as both SNs and novice RNs.

The impact of technology in society and particularly in educational settings is extensive and cha... more The impact of technology in society and particularly in educational settings is extensive and challenging to traditional notions of teacher-centred approaches to learning, learners and learning locations. New learning technologies, which include software such as learning management systems and eportfolios, collaborative learning approaches such as case and/or problem based learning and professional demands for curricula that facilitate both critical and inquiry-based learning, are now embedded within the higher education sector. This case study addresses a situation encountered by many health professionals who engage in teaching within a modern Australian university. Sally, a newly appointed lecturer who completed her preparation for practice degree in the early 2000s, and who believes herself to be a competent user of practice-related ICT and has extensive experience in clinical teaching (experiential learning), is bemused by her students’ use of technology during her first lecture...

This paper explores the dialectic between habitus and field (Bourdieu, 1977, 1990, 1998) for seve... more This paper explores the dialectic between habitus and field (Bourdieu, 1977, 1990, 1998) for several moments of nursing practice and then considers what an explication with more usual ways of making meaning in nursing might look like, eventually moving to an attempt to weigh up the various points of view on making or breaking meaning in these moments. It aims to ask: What do different approaches to the study of everyday practices of nursing tell us about how nurses provide care in the complex, dynamic and uncertain setting of the acute hospital ward? In the hospital setting, throughout the 24hr daily cycle of shift work, mediated by handover of patient status and progress, nurses attend to patient needs for care relevant to the course of the patient’s hospital stay. Each nurse will look after several patients for the duration of the shift so that there may be unfinished, competing and/or conflicting patient needs for care occurring simultaneously. Somehow nurses mostly address all t...

Background The nursing workplace relationships within a Neonatal Intensive Care Unit (NICU) invol... more Background The nursing workplace relationships within a Neonatal Intensive Care Unit (NICU) involve interactions and social relationships formed among nurses, doctors, allied health professionals and support staff involved in providing health care to neonates and their families. Today in an Australian NICU the staffs bring to their workplace a variety of life experiences, nationalities, backgrounds and cultures as well as their professional training/education. This paper is based on the review of literature that discusses an overview of what is already known about the nursing workplace relationships and specifically (i) the cultural practices embedded in NICU; (ii) nurses’ experience of everyday work in the NICU, (iii) what social interactions take place within the unit and (iv) how workplace relationships are constructed. Findings of Literature Review An extensive literature review of research about nurses’ relations at work has revealed very little about actual ward culture in gen...

Worldviews on Evidence-Based Nursing, 2011

Variability in clinical practice may result from the use of diverse information sources to guide ... more Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access and thus the variability in information may be contributing to clinical uncertainty.

Women and Birth, 2006

This paper will examine how the settings in which midwives practice (the birthplace) and models o... more This paper will examine how the settings in which midwives practice (the birthplace) and models of care affect midwives' decision making during the management of labour. One-hundred-and-four independent, team and hospital based midwives and 100 low obstetric risk nulliparous women to whom labour care was provided were surveyed. These midwives and women resided in the Auckland metropolitan area of New Zealand. The majority of midwives who participated worked in models of care which provided women with continuity of carer and care, however, this was not found to influence the way the midwives provided labour care. Instead, practice was found to be relatively homogenous regardless of whether the midwives worked in independent, team, or hospital-based practice. The birthplace setting in which the labour care took place did influence midwifery practice. The majority of midwives provided labour care in large obstetric hospitals and identified practices dominated by the medical model of care. Practice was described as being influenced by intervention and the need for technology, however, this did not prevent the majority of women from perceiving they were actively involved in the decision making process and that they worked in partnership with their midwives. Closer examination of the midwives' decision making processes whilst providing the labour care revealed that the midwives' individual decisions were influenced by the needs of the women rather than the hospital protocols. What became evident was that the midwives in this study had adopted a humanistic approach to care whereby technology was used alongside relationship-centred care.

Nursing Inquiry, 2012

WEST S, MAPEDZAHAMA V, AHERN M and RUDGE T. Nursing Inquiry 2012; 19: 177-187 [Epub ahead of print]

Journal of Midwifery & Women's Health, 2014

Aim: To synthesise current evidence on the effects of night-work on the major stages of women's r... more Aim: To synthesise current evidence on the effects of night-work on the major stages of women's reproductive health, specifically the menstrual cycle, fertility, pregnancy and menopause.

Journal of Clinical Nursing, 2010

Journal of Clinical Nursing, 2013

To explore the use of information by nurses making decisions in clinically uncertain situations i... more To explore the use of information by nurses making decisions in clinically uncertain situations in one aspect of critical care nursing practice (enteral feeding). In this paper, we report the characteristics, which participants identified as important, of the people from whom they sought information for the purpose of making clinical decisions. Background. Registered nurses have a plethora of information sources available to assist them in making clinical decisions. Identifying and selecting the best information to support these decisions can be difficult and is influenced by factors such as accessibility, usefulness and variations in quality of the information.

Intensive and Critical Care Nursing, 2006

Introduction: Enteral feeding is the preferred method of nutritional support for the critically i... more Introduction: Enteral feeding is the preferred method of nutritional support for the critically ill; however, a significant number of these patients are under-fed. It is possible that common nursing practices associated with the delivery of enteral feeding may contribute to under-feeding although there is little data available describing nursing practice in this area. Method: A descriptive survey-based design was used to explore the enteral feeding practices of 376 critical care nurses (response rate 50.5%). Participants completed a 57-item survey that focused on general enteral feeding practice and the management of feeding intolerance and complications. Results: The enteral feeding practice of critical care nurses varied widely and included some practices that could contribute to under-feeding in the critically ill. Practices associated with the measurement of gastric residual volumes (GRV) were identified as the most significant potential contributor to under-feeding. GRV measurements were commonly used to assess feeding tolerance (n = 338; 89.9%) and identified as a reason to delay feeding (n = 246; 65.4%). Delayed gastric emptying was frequently managed by prokinetic agents (n = 237; 63%) and decreasing the rate of feeding (n = 247; 65.7%) while nursing measures, such as changing patient position (n = 81; 21.5%) or checking tube placement (n = 94; 25%) were less frequently reported. Conclusion: The findings of this survey support the contention that nursing practices associated with the delivery of enteral feeds may contribute to under-feeding in the critically ill patient population.

Nurse education today, 2011

This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) exp... more This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) experienced their transition to acute care nursing practice.

Australian Critical Care, 2004

This article seeks to review the literature related to commencing enteral feeding, with particula... more This article seeks to review the literature related to commencing enteral feeding, with particular reference to the suitability of enteral nutrition, methods of enteral feeding and adjustment of enteral feeding rates. Issues relating to feeding intolerance, including the assessment of gastric residual volume and the development of diarrhoea, will also be explored.

Journal of Distance Education, Mar 13, 2010

The University of Sydney is a large, research-intensive, campus-based Australian University. Sinc... more The University of Sydney is a large, research-intensive, campus-based Australian University. Since 2004 a strategic initiative of project-based eLearning support has been creating teams of non-academic and academic staff, who have worked together to develop online resources to meet indentified needs. The University's aims in continuing to provide this framework are to engage academics in educational change and to implement innovation. Project management principles are intrinsic, including an extended application ...

Introduction: Despite improvements in revascularization, major amputation remains a significant p... more Introduction: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). Aim: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. Method: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed. Findings: Twenty-five patients had 29 major amputations including four conversions from below to above knee. Seventeen had multiple vascular procedures before amputation. The average LOS exceeded the national target, and there was substantial morbidity and 30-day mortality. Conclusion: Major amputation continues to present challenges because of patient frailty and the high rate of complications. These issues need to be considered in a robust care planning framework that includes consideration of cognitive decline and other markers of frailty. Opportunities to optimize the physical condition of these patients and to reduce delays in proceeding to surgery require further investigation. (J Vasc Nurs 2017;35:49-56)

Journal of the American College of Cardiology, 2014

International Journal of Health Care Quality Assurance, 25(6), 532 - 548

PURPOSE: The purpose of this paper is to describe the use of a common qualitative data set analys... more PURPOSE: The purpose of this paper is to describe the use of a common qualitative data set analysed with both a quality improvement tool to facilitate service improvement, and a rigorous research methodology to engage beginning nurse researchers in a mentored project.
DESIGN/METHODOLOGY/APPROACH: A qualitative cohort study of the experience of hospitalisation across six diagnostic groups interrogated data from 104 patient and carer interviews using the Picker Dimensions of Experience and Heideggerian Phenomenology.
FINDINGS: The paper reveals that well-conducted qualitative interviews can provide common ground for service improvement initiatives and rigorous research analysis.
RESEARCH LIMITATIONS/IMPLICATIONS: The Picker Dimensions use simple coding methods that push findings towards utility, but at times are overly reductionist and exile any data not related to hospital services. Heideggerian phenomenology is training and resource intensive, but its exploration of the meaning of the illness experience provides a profound backdrop for the subsequent understanding of hospitalisation.
PRACTICAL IMPLICATIONS: The access that qualitative data provides to the patient and family's perspective is becoming increasingly valued in processes of ongoing quality improvement, clinical redesign and evaluation for hospital accreditation.
SOCIAL IMPLICATIONS: The intrinsic rewards of deep qualitative analysis for the staff involved are extraordinary. Clinicians were humbled by new understandings, which surprised them despite their long clinical experience.
ORIGINALITY/VALUE: While quality improvement processes require training, ethics applications and data collection, the same framework can support rigorous qualitative research through use of the data as "common ground". The researchers experienced a tension, but eventually, a balance between the strengths and limitations of these combined modes of qualitative inquiry:

Background: The transition to practice of (novice) Registered Nurses (RNs) is commonly seen as a ... more Background: The transition to practice of (novice) Registered Nurses (RNs) is commonly seen as a simple process of “sliding” from one role to the other–Student Nurse (SN) to RN. How novice RNs accomplish moving from performing the role of SN to that of RN however, is rarely examined. Objective: To differentiate the performative roles of SNs and novice RNs.

Methods: Design: Interpretive qualitative design involving three sequential in-depth interviews during participants’ first year of practice; Setting: Australian metropolitan acute care hospitals; Participants: Nine Australian novice RNs; Procedure: Emergent themes were identified using constant comparative analysis and further conceptualised through development of a series of diagrams to determine how elements of these transition experiences might interact. Results: SNs rarely see the reality of performing as a novice RN until the role is actually upon them. While inextricably linked, these performances have become conflated into a conceptual continuum preventing acknowledgement of what are two distinct roles. Irving Goffman’s dramaturgical work was used to develop emergent understandings of how both SN and RN roles were each distinctly rehearsed and performed. Margaret Archer’s “inner conversation” was then used to develop an understanding of how novice RNs move between these roles.

Conclusions: Rather than assuming that SNs will adapt seamlessly to practice as novice RNs, attention needs to be given to differentiating the start and endpoints of this significant transition. Doing so will provide clarity around what educators expect of both roles and help those engaged in this transition to practice to celebrate their successes as both SNs and novice RNs.

The impact of technology in society and particularly in educational settings is extensive and cha... more The impact of technology in society and particularly in educational settings is extensive and challenging to traditional notions of teacher-centred approaches to learning, learners and learning locations. New learning technologies, which include software such as learning management systems and eportfolios, collaborative learning approaches such as case and/or problem based learning and professional demands for curricula that facilitate both critical and inquiry-based learning, are now embedded within the higher education sector. This case study addresses a situation encountered by many health professionals who engage in teaching within a modern Australian university. Sally, a newly appointed lecturer who completed her preparation for practice degree in the early 2000s, and who believes herself to be a competent user of practice-related ICT and has extensive experience in clinical teaching (experiential learning), is bemused by her students’ use of technology during her first lecture...

This paper explores the dialectic between habitus and field (Bourdieu, 1977, 1990, 1998) for seve... more This paper explores the dialectic between habitus and field (Bourdieu, 1977, 1990, 1998) for several moments of nursing practice and then considers what an explication with more usual ways of making meaning in nursing might look like, eventually moving to an attempt to weigh up the various points of view on making or breaking meaning in these moments. It aims to ask: What do different approaches to the study of everyday practices of nursing tell us about how nurses provide care in the complex, dynamic and uncertain setting of the acute hospital ward? In the hospital setting, throughout the 24hr daily cycle of shift work, mediated by handover of patient status and progress, nurses attend to patient needs for care relevant to the course of the patient’s hospital stay. Each nurse will look after several patients for the duration of the shift so that there may be unfinished, competing and/or conflicting patient needs for care occurring simultaneously. Somehow nurses mostly address all t...

Background The nursing workplace relationships within a Neonatal Intensive Care Unit (NICU) invol... more Background The nursing workplace relationships within a Neonatal Intensive Care Unit (NICU) involve interactions and social relationships formed among nurses, doctors, allied health professionals and support staff involved in providing health care to neonates and their families. Today in an Australian NICU the staffs bring to their workplace a variety of life experiences, nationalities, backgrounds and cultures as well as their professional training/education. This paper is based on the review of literature that discusses an overview of what is already known about the nursing workplace relationships and specifically (i) the cultural practices embedded in NICU; (ii) nurses’ experience of everyday work in the NICU, (iii) what social interactions take place within the unit and (iv) how workplace relationships are constructed. Findings of Literature Review An extensive literature review of research about nurses’ relations at work has revealed very little about actual ward culture in gen...

Worldviews on Evidence-Based Nursing, 2011

Variability in clinical practice may result from the use of diverse information sources to guide ... more Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access and thus the variability in information may be contributing to clinical uncertainty.

Women and Birth, 2006

This paper will examine how the settings in which midwives practice (the birthplace) and models o... more This paper will examine how the settings in which midwives practice (the birthplace) and models of care affect midwives' decision making during the management of labour. One-hundred-and-four independent, team and hospital based midwives and 100 low obstetric risk nulliparous women to whom labour care was provided were surveyed. These midwives and women resided in the Auckland metropolitan area of New Zealand. The majority of midwives who participated worked in models of care which provided women with continuity of carer and care, however, this was not found to influence the way the midwives provided labour care. Instead, practice was found to be relatively homogenous regardless of whether the midwives worked in independent, team, or hospital-based practice. The birthplace setting in which the labour care took place did influence midwifery practice. The majority of midwives provided labour care in large obstetric hospitals and identified practices dominated by the medical model of care. Practice was described as being influenced by intervention and the need for technology, however, this did not prevent the majority of women from perceiving they were actively involved in the decision making process and that they worked in partnership with their midwives. Closer examination of the midwives' decision making processes whilst providing the labour care revealed that the midwives' individual decisions were influenced by the needs of the women rather than the hospital protocols. What became evident was that the midwives in this study had adopted a humanistic approach to care whereby technology was used alongside relationship-centred care.

Nursing Inquiry, 2012

WEST S, MAPEDZAHAMA V, AHERN M and RUDGE T. Nursing Inquiry 2012; 19: 177-187 [Epub ahead of print]

Journal of Midwifery & Women's Health, 2014

Aim: To synthesise current evidence on the effects of night-work on the major stages of women's r... more Aim: To synthesise current evidence on the effects of night-work on the major stages of women's reproductive health, specifically the menstrual cycle, fertility, pregnancy and menopause.

Journal of Clinical Nursing, 2010

Journal of Clinical Nursing, 2013

To explore the use of information by nurses making decisions in clinically uncertain situations i... more To explore the use of information by nurses making decisions in clinically uncertain situations in one aspect of critical care nursing practice (enteral feeding). In this paper, we report the characteristics, which participants identified as important, of the people from whom they sought information for the purpose of making clinical decisions. Background. Registered nurses have a plethora of information sources available to assist them in making clinical decisions. Identifying and selecting the best information to support these decisions can be difficult and is influenced by factors such as accessibility, usefulness and variations in quality of the information.

Intensive and Critical Care Nursing, 2006

Introduction: Enteral feeding is the preferred method of nutritional support for the critically i... more Introduction: Enteral feeding is the preferred method of nutritional support for the critically ill; however, a significant number of these patients are under-fed. It is possible that common nursing practices associated with the delivery of enteral feeding may contribute to under-feeding although there is little data available describing nursing practice in this area. Method: A descriptive survey-based design was used to explore the enteral feeding practices of 376 critical care nurses (response rate 50.5%). Participants completed a 57-item survey that focused on general enteral feeding practice and the management of feeding intolerance and complications. Results: The enteral feeding practice of critical care nurses varied widely and included some practices that could contribute to under-feeding in the critically ill. Practices associated with the measurement of gastric residual volumes (GRV) were identified as the most significant potential contributor to under-feeding. GRV measurements were commonly used to assess feeding tolerance (n = 338; 89.9%) and identified as a reason to delay feeding (n = 246; 65.4%). Delayed gastric emptying was frequently managed by prokinetic agents (n = 237; 63%) and decreasing the rate of feeding (n = 247; 65.7%) while nursing measures, such as changing patient position (n = 81; 21.5%) or checking tube placement (n = 94; 25%) were less frequently reported. Conclusion: The findings of this survey support the contention that nursing practices associated with the delivery of enteral feeds may contribute to under-feeding in the critically ill patient population.

Nurse education today, 2011

This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) exp... more This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) experienced their transition to acute care nursing practice.

Australian Critical Care, 2004

This article seeks to review the literature related to commencing enteral feeding, with particula... more This article seeks to review the literature related to commencing enteral feeding, with particular reference to the suitability of enteral nutrition, methods of enteral feeding and adjustment of enteral feeding rates. Issues relating to feeding intolerance, including the assessment of gastric residual volume and the development of diarrhoea, will also be explored.

Journal of Distance Education, Mar 13, 2010

The University of Sydney is a large, research-intensive, campus-based Australian University. Sinc... more The University of Sydney is a large, research-intensive, campus-based Australian University. Since 2004 a strategic initiative of project-based eLearning support has been creating teams of non-academic and academic staff, who have worked together to develop online resources to meet indentified needs. The University's aims in continuing to provide this framework are to engage academics in educational change and to implement innovation. Project management principles are intrinsic, including an extended application ...